Should colonoscopy be the first investigation for colonic disease?

Many patients with suspected colonic disease undergo rigid sigmoidoscopy, barium enema examination, and ultimately total colonoscopy, but the need for preliminary radiology has not been formally assessed. A total of 168 patients requiring large bowel investigation were therefore randomised to undergo either rigid sigmoidoscopy plus double contrast barium enema examination or total colonoscopy. Disease was found in 56 patients, including 14 with a carcinoma, 11 with polyps, and 16 with inflammatory bowel disease, the remainder having diverticular disease alone. Of the 89 patients allocated to double contrast barium enema examination, nine required a subsequent colonoscopy for suspected tumour or polyps, three because of incomplete radiological examination, and 12 for rectal bleeding for which no cause was found at the radiological examination. In 16 patients this yielded further information or altered treatment. Of the 79 patients undergoing total colonoscopy, only six required subsequent radiology.As both procedures were well tolerated with no major complications total colonoscopy may be the preferred initial investigation where facilities allow.     

Inequalities in women's health: looking at mortality differentials using an alternative approach

Data obtained from follow up of the 1971 census sample in the Office of Population Censuses and Surveys longitudinal study of England and Wales were used to look at women''s mortality differentials at ages 15-59. Women were grouped by combining information on marital state, own occupation, husband''s occupation (if married), economic activity, and indicators of household wealth (housing tenure and access to a car). Large groups were found with considerable differences in mortality. High mortality was associated with working in manual occupations and living in rented housing with no car in the household. In contrast, low mortality was associated with non-manual occupations and living in owner occupied housing with a car. Among married housewives and single women these extreme groups contributed 44% of expected deaths, the disadvantaged group experiencing death rates two and a half times that of the advantaged group. Smaller differences were found among married women with an occupational class.These findings are further evidence of the “health divide” in England and Wales and show that accurately to reflect the relation between a woman''s life circumstances and mortality it is necessary to utilise other measures than those based solely on occupation.     

A scanning and transmission electron microscopic study of the lung of a caecilian Boulengerula taitanus

The lung of an apodan amphibian Bouiengerula taitanus has been investigated by scanning and transmission electron microscopy. This caecilian has only a single, long tubular lung that tapers towards the caudal end of the body. The lung has a central air duct which radially opens into a single stratum of alveoli lined by well developed septa that attach to two diametrically opposite trabeculae. The trabeculae carry the pulmonary artery and vein. The septa have blood capillaries on both surfaces and supportive and contractile elements like collagen, smooth muscle, elastic tissue and fibrocytes. The alveolar surface has only a single population of pneumocytes that combine the morphological features of the mammalian type 1 and 2 cells, i.e. they contain the osmiophilic, lamellated bodies and are squamous in form. Through subepithelial cytoplasmic invaginations, the pneumocytes, together with their basement lamina, were observed to be firmly attached to the septa1 tissue elements, presumably to avoid mechanical detachment during the rapid respiratory movements. The compartmentation of the whole lung in this species is viewed as a means of increasing the surface area available for gas exchange which, coupled with other already established cardiovascular adaptations in this species, may be of significance in its fossorial mode of life, an environment that is usually hypoxic and hypercarbic.     

Neural function: metabolism and actions of inositol metabolites in mammalian brain

In the nervous system, a variety of cell types respond to external stimuli through the inositol lipid signalling pathways. The stimulus-coupled sequence of intracellular events has been investigated in a homogeneous model system, the cloned mammalian neural cell line NG115-401L. The neural peptide bradykinin stimulates a rapid production of identified inositol phosphate isomers and an intracellular Ca2+ discharge followed by a persistent plasma membrane influx. The temporal sequence suggests that Ins(1,4,5)P3 or Ins(1,3,4,5)P4 or both may coordinate these events in a neuronal cell, as has been suggested in other cell types. Thapsigargin, an irritant and tumour-promoting plant product, produces calcium transients in the absence of inositol phosphate production, and may provide a new tool for investigating the interactions between inositol phosphates and changes in cellular calcium homeostasis. In the 401L line, high levels of radiolabelled InsP5 and InsP6 have been detected, which has led to the evaluation of their possible occurrence and actions in normal brain. Both InsP5 and InsP6 are produced from a radiolabelled myo-inositol precursor in intact mature brain in a region-specific manner. This suggests that both inositol polyphosphates may be end products of regionally regulated biosynthetic pathways. When microinjected into a nucleus of the brainstem, or iontophoretically applied to the dorsal horn of the spinal cord, both InsP5 and InsP6, but not Ins(1,3,4,5)P4 isomers, appear to be potent neural stimulants. These results suggest that the inositol lipid signalling pathways may generate both intracellular and extracellular signals in brain.     

Mechanisms in volume regulation in Ehrlich ascites tumor cells

The Ehrlich ascites tumor cell has been used as a model of an unspecialized mammalian cell, in an attempt to disclose the mechanisms involved in the regulation of cellular water and salt content. In hypotonic medium Ehrlich cells initially swell as nearly perfect osmometers, but subsequently recover their volume within about 10 min with an associated net loss of KCl, amino acids, taurine and cell water. The net loss of KCl takes place mainly via separate, conductive K+ and Cl- transport pathways, and the net loss of taurine through a passive leak pathway. Ca2+ and calmodulin appear to be involved in the activation of the K+ and Cl- channels, as well as the taurine leak pathway. In hypertonic medium Ehrlich cells initially shrink as osmometers, but subsequently recover their volume with an associated net uptake of KCl and water. In this case, the net uptake of KCl is the result of the activation of an electroneutral, Na+- and Cl- -dependent cotransport system with subsequent replacement of cellular Na+ by extracellular K+ via the Na+/K+ pump. In the present review we describe the ion and taurine transporting systems which have been identified in the plasma membrane of the Ehrlich ascites tumor cell. We have emphasized the selectivity of these transport pathways and their activation mechanisms. Finally, we propose a model for the activation of the conductive K+ and Cl- transport pathways in Ehrlich cells which includes Ca2+, leukotrienes, and inositol phosphate as intracellular second messengers.     

Mechanisms of tetracycline and rifampicin resistance inBacteroides fragilis mutants obtained by ionizing radiation

Summary Based on a dose-survival curve, a radiation dose of 3.99 C/kg was used to induce antibiotic-resistant mutants inBacteroides fragilis. Escherichia coli B/r membrane fragments were employed as a reducing agent. Antibiotic-resistant mutants ofB. fragilis were utilized to study the mechanism by which these organisms become resistant to selected chemotherapeutic agents. Decreased accumulation of tetracycline by resistant mutants ofB. fragilis suggests that the resistance to this antibiotic is associated with the outer membrane permeability. There is a marked difference in the inhibitory action of rifampicin on RNA polymerase activity in rifampicin-sensitive and-resistant strains ofB. fragilis. This enzyme is, therefore, the likely target for inhibition of bacterial growth in this anaerobe by rifampicin.     

Incorporation of an antineoplastic drug aclarubicin into liposomes in relation to the conditions of its encapsulation]

The results of liposome drug encapsulation of aclarubicin (aclacinomycin A), an antitumor antibiotic, are presented. The method of flow detergent dialysis was applied. Conditions providing maximum encapsulation of aclarubicin (the ratio of lipid components and the lipid/detergent ratio), as well as conditions providing stability of liposomal emulsion (the presence of antioxidants, stearic acid and cholesterol) were defined.     

The effect of taurine on the activity of transport ATPases and of energy metabolism enzymes in different tissues of rats with acute hypoxic hypoxia]

The membrane activity of Na+, K(+)-ATPase, Mg2+, Ca(2+)-ATPase, mitochondrial NAD-isocitrate dehydrogenase, mitochondrial and cytosolic L-glycerol-3-phosphate dehydrogenase was determined in the liver and brain of Wistar rats under acute hypoxic hypoxia against the background of preventive taurine administration. It was shown that preliminary taurine treatment prevented a decrease of hypoxia in activity of Na+. K(+)-ATPase and mitochondrial calcium-dependent enzymes, mostly in the liver. Changes in the intracellular calcium content and biomembrane structure have been discussed as the mechanisms of the taurine effect on the enzymes' activity.     

The history of the theory of nervous trophism]

Concepts "trophism" and "nervous trophism", development of views on trophic function of the nervous system and its disorders (neurogenic dystrophies) are reviewed. The problem on the ways of the trophic effects of the nervous system on the tissues is considered. The role of neuromediators in this process, particularly the significance of balance of norepinephrine, (NE), a mediator of the sympathetic nervous system (SNS), for maintaining trophism of tissues, their structure and functions is emphasized. The activating role of SNS and NE in the resistance and reparative regeneration of different tissues is shown under the experimental and clinical conditions. In this view a comprehensive definition of concepts "nervous trophism" is given.